Provider Demographics
NPI:1447688700
Name:NUNEZ, MAYRA VASQUEZ (RD)
Entity type:Individual
Prefix:
First Name:MAYRA
Middle Name:VASQUEZ
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 E NOB HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-3534
Mailing Address - Country:US
Mailing Address - Phone:509-248-3334
Mailing Address - Fax:509-452-1625
Practice Address - Street 1:602 E NOB HILL BLVD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-3534
Practice Address - Country:US
Practice Address - Phone:509-248-3334
Practice Address - Fax:509-452-1625
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60428431133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered